Jill Riedmiller
Bellefontaine,OH
Summary
Accomplished Clinical Financial Case Management Specialist 2 at The James Cancer Hospital, adept in regulatory compliance and reimbursement. Recognized for exceptional written and verbal communication, securing hospital reimbursements, and fostering significant interdepartmental relationships. Awarded for compassion, underscoring a commitment to ethical practice and patient-centered outcomes.
Overview
18
18
years of professional experience
Work History
Clinical Financial Case Management Specialist 2
The James Cancer Hospital
11.2018 - Current
- Manage denials related to outpatient chemotherapy care through submission of appeals providing clinical knowledge and scientific evidence to support treatment with cutting edge therapies and diagnostic services.
- Pursue hospital reimbursement for patient services through conference calls with payers, submission of appeals, identification of coding errors and additional communication with internal staff to encourage completion of prior authorizations and proper billing.
- Active learner seeking knowledge of up-to-date medical research, trends in medical billing and reimbursement, along with expertise in payer practices.
- Foster effective relationships with internal and external partners to provide patient centered care.
- Provide verbal and written communication at an exceptional level to support the misson of seeking proper reimbursement for patient services provided.
Social Worker IV
Ohio Health - Dublin Methodist Hospital
06.2012 - 11.2018
- Provided excellent support and care to patients and families experiencing the stress of being ill while also navigating the ever-changing health care system and services available to them.
- Skillfully worked with skilled nursing rehab centers, home heath care agencies, mental health agencies, and other community supports to refer patients to the appropriate services.
- Collaborated daily with multidisciplinary teams to establish safe discharge plans for the hospital's highest acuity patients.
- Consistently treated patients and families with respect and dignity which was recognized be several Power of One statements from patients and colleagues.
- Leader within my department promoting a positive work environment that encourages team work paired with strong communication.
- Won System Prism Award for demonstrating compassion. An award given to few employees who promote the highest quality of care for patients.
School Outreach Coordinator
Bellefontaine City Schools
03.2009 - 06.2012
- Facilitated collaboration among teachers, staff, and administrators to address student needs and improve academic performance.
- Linked families to community resources including but not limited to: counseling, parenting classes, housing assistance, financial assistance, health care, food assistance, and holiday assistance.
- Served on Board of Directors for the Community OUtreach Centers of Logan County.
Foster Care and Adoption Therapist
Adriel Inc
05.2008 - 02.2009
- Built strong rapport with clients, fostering trust and open communication for effective therapy sessions.
- Maintained detailed case notes and documentation, ensuring effective tracking of progress and continuity of care across providers.
- Advocated for youth's individual needs while working in collaboration with various professionals assigned to each case including county caseworkers, court officials and school officials.
Foster Care Program Manager
Dungarvin, Ohio
05.2007 - 02.2009
- Facilitated workshops and conducted one-on-one training to educate foster care parents and staff hired to work with youth with developmental disabilities in foster care.
- Managed and supervised administrative and daily program operations, complying with policies and regulations.
Family Preservation Therapist
St. Aloysius Orphanage
06.2006 - 05.2007
- Provided intensive home based therapy to youth involved with the juvenile justices system through individual and family therapy sessions.
- Improved patient outcomes by implementing evidence-based therapeutic techniques and interventions.
- Collaborated with the juvenile justices system and schools to wrap services around youth to encourage positive outcomes.
Education
Master of Arts - Social Work
Ohio University
Athens, OH06.2006
Social Work
Ohio University
Athens, OH06.2005
Skills
- Client Advocacy
- Meet/Exceed Compliance Standards
- Utilization Management
- Data Collection and Analysis
- Written and verbal communication
- Policy Knowledge
- Build collaborative relationships
- Care Coordination
- Healthcare experience as front line provider
- Healthcare experience in reimbursement
Timeline
Clinical Financial Case Management Specialist 2
The James Cancer Hospital
11.2018 - Current
Social Worker IV
Ohio Health - Dublin Methodist Hospital
06.2012 - 11.2018
School Outreach Coordinator
Bellefontaine City Schools
03.2009 - 06.2012
Foster Care and Adoption Therapist
Adriel Inc
05.2008 - 02.2009
Foster Care Program Manager
Dungarvin, Ohio
05.2007 - 02.2009
Family Preservation Therapist
St. Aloysius Orphanage
06.2006 - 05.2007
Master of Arts - Social Work
Ohio University
Social Work
Ohio University
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